We provide care for the entire foot—including your nails.
Toenails can provide early signs of other conditions. For example, pitted toenails with increased
thickness can indicate psoriasis. Any toenail discoloration or infection should be evaluated by your
doctor. Many of the conditions we regularly see can be resolved with topical or oral medications.
Below are some of the nail conditions we treat on a daily basis.
BLACK TOENAIL
Description
Subungual hematoma (black toenail) is blood trapped beneath the toenail. It’s usually caused by blunt trauma; dropping a heavy object on the toe or chronic friction from rubbing against the shoe, which is common in runners.
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Symptoms
A black, purple, or red area under the nail. The nail may come loose, but will most often stay intact and the bruise fades as the nail grows out. If the subungual hematoma is large and causing pain, medical treatment is needed.
Treatment
Most cases require no treatment, although a biopsy of the nail may be performed. If your doctor determines that the melanonychia is secondary to a systemic condition and/or dermatologic disease, the underlying condition must be treated.
DARK STREAK
Description
Melanonychia is a tan, brown or black lengthwise streak or line on the toenail plate caused by increased melanin production. It is most common in people with darker skin and affects up to 77% of African Americans over the age of 20 and almost 100% of those over 50.
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Symptoms
A dark line running lengthwise on the toenail (usually the big toe). Melanonychia does not cause pain. The wider and darker the streak is, the greater the concern of malignancy. Fortunately, very few people with Melanonychia actually have subungual (nail) melanoma.
Treatment
Most cases require no treatment, although a biopsy of the nail may be performed. If your doctor determines that the melanonychia is secondary to a systemic condition and/or dermatologic disease, the underlying condition must be addressed.
INGROWN TOENAIL
Description
An ingrown toenail occurs when a sharp corner of the toenail digs into the skin at the end of, or side of, the toe. Any toenail can become ingrown, but the condition is primarily found in the big toe.
Symptoms
Pain and inflammation at the spot where the nail digs into the skin. The inflamed area may grow extra tissue or drain yellowish fluid. Left untreated, an ingrown toenail can progress to an infection or even an abscess that requires surgical treatment.
Treatment
Treatment involves removing the offending nail border. This procedure is performed in our office and usually takes about ten minutes. You will likely be able to leave our office in the very shoes you arrived in. Aftercare includes daily soaking and topical antibiotics.
RAM’S HORN NAILS
Description
Onychogryphosis is a condition in which the toenails thicken and adopt a severe curve causing them to grow into long, curved shapes resembling a ram’s horn.
Symptoms
The toenails are yellowish-brown, thick, curved, and indeed look more like horns than nails. As the nails are no longer flat, trimming with clippers or scissors is nearly impossible.
Treatment
Removal of the nail is common and can be performed relatively painlessly. If the condition is treated early, you stand an excellent chance of avoiding the pain, inflammation, and various infections that could otherwise result.
TOENAIL FUNGUS
Description
Onychomycosis is the most common nail disease in adults. Toenails are far more likely to be affected than fingernails. As many as 90% of elderly people have the condition. Its frequency is increasing and is related to diabetes and suppressed immunity.
Symptoms
Discolored, thickening toenails which can disfigure or split. The condition starts as a cosmetic concern. However, if untreated, it can progress to where the nails become so thick that they press against the insides of the shoes and cause pain.
Treatment
Toenail Fungus is commonly treated with antifungal creams or gels and/or oral medication. Regular nail trimming is essential. Rarely, a severe case may require one or more of the infected toenails to be surgically removed.
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Focus Sports Medicine, Minimally-Invasive Bunion Correction, Arthroscopy, Cartilage Transplantation, Non-Surgical Techniques, and General Foot Care
Undergraduate at Temple University
Temple University School of Podiatric Medicine in Philadelphia.
Surgical residency Jersey Shore University Medical Center
Board certified by the American Board of Podiatric Medicine and Board Qualified in Foot and Reconstructive Rearfoot/Ankle Surgery
Member of the American Podiatric Medical Association and the American College of Foot and Ankle Surgeons
Dr. Jessica Fink
Focus Deformity Correction utilizing both internal and external fixation, Minimally Invasive Surgery, and Orthoplastics
Undergraduate at Keuka College
New York College of Podiatric Medicine in New York City
Surgical residency Baltimore VA Medical Center
Board certified the American Podiatric Medical Association and Board Qualified in Foot and Ankle Surgery by the American Board of Foot and Ankle Surgery
Member of the American Podiatric Medical Association, American College of Foot & Ankle Surgeons, American College of Foot and Ankle Orthopedics and Medicine, American Society of Podiatric Surgeons, and American Association for Women Podiatrists
Dr. Harold Cook
Focus orthopedics, rehabilitation, rheumatology, infectious disease, trauma, pathology and microbiology
Undergraduate at Ohio State University
Kent State University College of Podiatric Medicine
Surgical residency Bellevue Hospital Center, the flagship hospital of the New York City Health and Hospitals Corporation
Board certified by the American Board of Podiatric Medicine and Board Qualified in Foot and Reconstructive Rearfoot/Ankle Surgery
Dolly Stelzer, DPM
Focus on sports medicine
Undergraduate, University of Florida
Graduate, New York College of Podiatric Medicine
Residency in Podiatric Medicine and foot and ankle surgery at Denver DVA
Board Certified, American Board of Podiatric Medicine
Board Qualified, American Board of Foot Ankle Surgery
Robyn Adams
Focus on orthotics and diabetic footwear
Towson University BS – Kinesiology/ Education
Kennesaw State University – Pedorthics
Member, Pedorthic Footcare Association
Dr. Torian
Natalie Mccoy, C.Ped
Focus on diabetic shoe fitting
Pedorthist Certification, Kennesaw State University
Diabetic Shoe Fitter Certification, The American Board for Certification in orthotics, prosthetics and pedorthist.
Démon Thompson, C.Ped
Focus on orthotics and ankle foot orthoses
Medical training at Army Medical Corps, San Antonio, Texas
International School of Pedorthics
Member, American Academy of Podiatric Practice Management
Member, Pedorthic Foot care Association
Member. The American Diabetes Association
James M. Cawthorne, DPM
Focus on diabetic foot care and foot surgery
Undergraduate, Westminster College
Ohio College of Podiatric Medicine
Residency in foot surgery at McNamara Hospital
Member, South Carolina Podiatric Medical Association
Member, American Podiatric Medical Association.
Walter H. Singleton, DPM
Focus on pharmacology
Undergraduate, Medical University of South Carolina and The Citadel
Ohio College of Podiatric Medicine.
Residency, Veterans’ Administration Medical Center in Huntington, WV
Member, South Carolina Podiatric Medical Association